Tag: Jurisdiction D
CMS re-awards contract to Noridian
March 7, 2024HME News Staff
FARGO, N.D. – Noridian Healthcare Solutions has again been awarded the DME MAC for Jurisdiction D contract by CMS. The $152.8 million contract covers 17 states and three U.S. Territories. Noridian processes more than 13 million fee-for-service (FFS) claims for nearly 25,000 DME suppliers, resulting in $2.6 billion in payments for the contract. “We are immensely proud to receive this re-award,” said Noridian president and CEO Jon Bogenreif. “For nearly two decades, Noridian...
DME MAC offers new online tool
December 1, 2016HME News Staff
NASHVILLE - CGS Administrators, the Jurisdiction B DME MAC, has launched Mr. Wizard, an online tool that provides detailed information on claims under review and the status of additional documentation requests. Providers simply enter their 14-digit claim control number to receive information on type of denial received and detailed explanation; provider NPI; date of service, code billed, and links to education and resources for particular denials.
Jurisdiction D finds 21% error rate for concentrators
January 8, 2015HME News Staff
FARGO, N.D. -A documentation compliance review for oxygen concentrators (E1390) from Sept. 1, 2014, to Nov. 30, 2014, resulted in an overall error rate of 21%, according to the Jurisdiction D DME MAC. The most common reasons for denial: proof of delivery (POD) was not submitted or was invalid; no documentation to support the beneficiary had been seen and evaluated by the treating physician within 30 days prior to the date of the initial Certificate of Medical Necessity (CMN); and no request documentation...
Jurisdiction D to conduct neb-med review
November 12, 2014HME News Staff
FARGO, N.D. - The Jurisdiction D DME MAC is conducting a documentation compliance review for nebulizer inhalation drugs (J7605 and J7626). The purpose is to verify whether submitted documentation meets payment requirements according to local coverage determinations. To avoid denial, providers should ensure requested documentation is sent to the contractor within the allotted timeframe, medical records supporting the management of obstructive pulmonary disease are submitted and refill requirements...
DME MAC changes name
May 13, 2013HME News Staff
WASHINGTON - Noridian Administrative Services, the DME MAC for Jurisdiction D, has changed its name to Noridian Healthcare Solutions, the organization announced in a message to its mailing list. The name change reflects some of Noridian's newer initiatives that branch out from its core business, including broader administrative services; program integrity offerings to mitigate fraud and abuse; and care and delivery management solutions designed to expand care and reduce patient care costs.
Probe finds 98% error rate for enteral
December 14, 2012HME News Staff
WASHINGTON - A prepayment probe by the Jurisdiction D DME MAC found that 98 of 100 reviewed enteral claims were denied because of various primary documentation errors, according to a CMS bulletin. Twenty-four percent of claims were denied because of invalid beneficiary exhaustion, meaning suppliers did not receive refill requests from beneficiaries prior to dispensing. Fourteen percent of claims were denied because they lacked a detailed written order (DWO) either written or reviewed by the ordering...